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Updated: Nov 10, 2025
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Feasibility and Safety of Lateral Pelvic Lymph Node Dissection After Neoadjuvant Chemoradiotherapy for Elderly
Kyosuke Agawa1, Takeru Matsuda2,3, Kimihiro Yamashita1
1Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Background/Aim:
The safety of neoadjuvant chemoradiotherapy (NACRT) combined with total mesorectal excision (TME) and selective lateral pelvic lymph node dissection (LLND) is unclear in elderly patients with locally advanced rectal cancer (LARC).
Patients And Methods:
Forty-two patients with LARC underwent TME and selective LLND following NACRT at Kobe University Hospital. The clinical outcomes were retrospectively compared between the elderly (aged ≥70 years, n=13) and non-elderly patients (aged <70, n=29).
Results:
Twelve of the thirteen elderly patients could complete NACRT. Although the overall rate of postoperative complications did not differ between the groups, abdominal wound infection and deep vein thrombosis developed more frequently in the elderly group. The length of the postoperative hospital stay was similar. Three-year overall survival and 3-year relapse-free survival rates were similar between the groups.
Conclusion:
Selective LLND after NACRT is safe for elderly patients with LARC.
